Ticket for Outdoor Patient
| Ward No. 3 | U-PHC No. | Registration No. 07017 | Date 29/11/2019 |
| Token No | SM/19-20/16021 30/12/2019 | Serial | 010 Last Visit: 30/12/2019 |
| Patient Name | Miss TRISHNA MALAKAR | Contact No | 9836267739 |
| Address | 18/16 GURUDAS BHATTACHARJEE LANE CHATRA , BAIDYBATI(M) | Age | 9 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 19 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||